Document k94xpvJ3p8bV8Dp6VLQg7KmZ0

(/Li A p ril % 1939 . . Mr. f , ! S . McEldbwney (Milt 011 C orporation Uulf Building P itts b u rg h *-Pa. ; - * Dear Mr. MeEl&owneyj* X wish to th&nh you fo r th e inform ation which you have a e n t m e w i t h referen ce to th e case o f a lle g e d l e a l poisoning in Mr. X have a fear comments to : sake concerning the a n a ly tic a l r e s u lts o b tain ed on the bloo&. X a s not s u rp ris e d th a t the blood a n a ly s is was not done a t the U niversity of Pensylvania g o s p lta l but ra th e r a t the Jefferson H ospital. J have been fam iliar f o r some tim e w ith the worh being done a t th e J e ffe rs o n H o s p ita l, and X am a ls o fa m ilia r w ith t h e i r methods of a n a ly s is . X have no doubt th a t th e r e s u l t obtained on the blood sample was e n t i r e l y ac c u ra te so f a r as th e le a d co n ten t o f th e sample subm itted i s concerned. On th e o th e r hand I t i s quite p o ssib le th a t the sample in q u estio n was c o lle c te d a t th e U n iv e rsity o f Pennsylvania H o sp ital and by methods which would n o t guarantee i t a g a in s t s l i ^ a t contam ination w ith le a d , f h is f a c t may account f o r th e somewhat e le v a te d r e s u l t . Be t h a t as i t may, th e r e s u l t obtained on t h i s one Sample does s o t : provide su ffic ie n t evidence to Ju stify a diagnosis of acu te le a d p o iso n in g . As a m a tte r of .f a c t , i f th e r e s u l t be accepted as e n tire ly accurate and representative of the f a c ts w ith re s p e c t to Mf, -blood* i t i s s t i l l n o t a s u f f ic ie n t,b a s is fo r the d iag n o sis. X b e lie v e th a t no .. . one w ith adequate experience in the f ie ld would be w illin g to hazard such a diagnosis on th e b a sis o f th is a n a ly tic a l r e s u l t alo n e. When tahen w ith th e e s s e n tia lly neg ativ e h isto ry of exposure and w ith the other c lin ic a l findings* and p a rtic u la rly the absence of any microscop io changes in the blood, the diagnosis is d is tin c tly not Ju stifie d . . In view o f Mr. p re se n t condition* i t does not seem to be necessary to tahe any f u r th e r a c tio n a t t h i s tim e. However I th ln h In view o f th e one a n a ly tic a l r e s u l t which has been obtained* i t would be q u l t e u a e f u l t o ob tain fu rth e r samples o f blood and u rin e f o r a n a ly s is f o r bur own in fo rm atio n . I f t h i s 409R & O A be p le a se d to send to his o f to his d o ctor . '''^ h ta ln e rs fo r the co llectio n of such samples and d e ta ile d In stru c tio n s as to th e p recise manner in which they should he c o lle c te d . With one o r more samples o f blood and w ith ' a la rg e sample-of urine available* I fe e l quite c e rta in vittMrtClwe could come to some d e f in ite conclusion as to th e adequacy, o f th e a n a ly s is th a t has been performed* 2 would s o suggest on a d d itio n a l point* I should l ik e to know f o r my own inform ation where* and by what means the sample o f b lo u d was c o lle c te d which was s e n t to .the Jefferson H ospital laboratory* I t o fte n happens th a t a sample of blood i s drawn by use o f an ordinary needle and syringe in to a t e s t tube o r o th er container which has hot been p rep ared f o r th e purpose. We have found I t e n tir e ly necessary* in order to avoid high re su lts * to supply a sp ecial needle which i s chem ically clean* to avoid the use o f a syringe a lto g e th e r, and to draw th e blood in to a c o n ta in e r which we supply from the la b o ra to ry . X know that the people a t the Jefferson Hospital laboratory follow t h i s same procedure* b u t I a lso know th a t from time to time diagnostic la b o ra to rie s receive samples which have not been c o lle c te d according to t h e i r own tech n iq u e. I t i s p o ssib le that th at occurred in th is case*, ' ` The item s o f Inform ation and the fu rth e r c o lle c tio n o f samples which I have suggested would be q u ite necessary I f th ere are lik e ly to be any 7-leg al: eonplication In th isy ia se . I f th ere are not such 7 com plications and i f Mr* is quite sa tisfie d in his ow^ mind th a t he d id n o t have lead, poisoning* th en I t may be in a d v isa b le to tak e th e f u r th e r s te p s which I haw* suggested. 1 leave th is m atter in your hands fo r decision, n e v e rth e le s s fo r my own purposes* X should be glad to make any fu rth e r in v estig atio n which is fe a sib le in order to s a t i s f y m yself on th e fa c ta in t h i s case* _ Xou might even f e e l th a t you would be j u s t if ie d In sending M r * t o C incinnati for a complete and thorough examination, ib i s , would seem improbable but* on the o th e r hand* i f you f e a r l e g a l d i f f i c u l t i e s * I t m ight be very, wise to do so . I s h a ll await your further advice i f there is anything further th at you w ish me t o do* Tory tru ly yours* HAKjls R obert'A. lKehoe,''rM"'b. 0810333